Question 1

In order to prevent uterine inversion, one should not employ any method to expel the placenta out of the body when the uterus is relaxed (and pulling of the umbilical cord simultaneous with fundal pressure should be avoided). Of the following, which is proper management specifically for uterine inversion?

Accepted Answer

Urgent manual replacement (of the uterus)
Uterine inversion is a rare complication in the third stage of labor, in which the uterus is (incompletely or completely) turned "inside out". There are three degrees of uterine inversion as follows: 1) First degree (in which the inverted fundus extends to-but not through- the cervix); 2) Second degree (in which the inverted fundus extends through the cervix, but remains within the vagina); and 3) Third degree (in which the inverted fundus extends outside of the vagina).
Management for inversion of the uterus includes:
1. Urgent manual replacement (of the uterus)
2. Correction of dehydration and ketoacidosis
3. Blood transfusion
4. Nothing by mouth
5. I.V. fluid administration
6. Oxygen administration
7. Analgesic administration

Question 2

Complications of pregnancy can cause permanent disability or maternal death. Which of the following can be a cause of maternal death?

Accepted Answer

All of the above
Common causes of maternal death (mortality) include:
1. Hemorrhage
2. Retained placenta
3. Ectopic pregnancy
4. Sepsis
5. Unsafe abortion
6. Eclampsia
7. Viral hepatitis
8. Hepatic coma

Question 3

Complications of pregnancy can cause permanent disability or maternal death. Which of the following steps can reduce maternal mortality?

Accepted Answer

All of the above
Reduction of the maternal mortality rate is associated with the following:
1. Prenatal, intranatal, and antenatal care
2. A well - trained and skilled person assisting with childbirth
3. Emergency obstetrical intervention and treatment
4. Pre - conception and family planning consultation
5. Access to obstetrical healthcare unit
6. Public health education programs for pregnant women
7. Increased response rate to obstetrical emergencies

Question 4

After 28 weeks of pregnancy, a woman gives birth to a newborn with no heart beat or respiration (nor any sign of life) upon delivery. What is the term applied to this type of birth?

Accepted Answer

Stillbirth
A stillbirth occurs when a fetus dies in the uterus or during labor (after 20 weeks of pregnancy). Causes of stillbirth include:
1. Birth asphyxia and trauma
2. Abruptio placenta
3. Preeclampsia
4. Fetal complications and chromosomal abnormalities
5. Infection

Question 5

After 28 weeks of pregnancy, a woman gives birth to a newborn with no heart beat or respiration (nor any sign of life) upon delivery. Of the following, which is a cause of stillbirth?

Accepted Answer

All of the above
A stillbirth occurs when a fetus dies in the uterus or during labor (after 20 weeks of pregnancy). Causes of stillbirth include:
1. Birth asphyxia and trauma
2. Abruptio placenta
3. Preeclampsia
4. Fetal complications and chromosomal abnormalities
5. Infection

Question 6

Antepartum death occurring beyond 20 weeks of pregnancy is called intrauterine death or stillbirth. Which of the following is a fetal cause intrauterine death due to an imcompatible blood type?

Accepted Answer

Rh incompatibility
When a mother has Rh - negative blood and the fetus has Rh - positive blood, Rh incompatibility results. The impact of the blood type incompatibility is that the mother's blood makes antibodies against the fetal blood cells. These anti - Rh antibodies can then cross through the placenta into the bloodstream of the fetus (destroying the circulating red blood cells in the fetus), and causing a fetal build - up of bilirubin. For this reason, the newborn often appears jaundiced. Rh incompatibility effects on the fetus can range from mild to fatal, depending on the level of hemolytic anemia in the fetus.
Fetal causes of intrauterine death and stillbirth include:
1. Chromosomal abnormalities
2. Fetal infections
3. Rh incompatibility

Question 7

A second gravida is (at 35 weeks of pregnancy) has experienced no fetal movement for two days. Which of the following is a probable diagnosis?

Accepted Answer

Intrauterine death
Interruption of pregnancy with death of the fetus beyond 20 weeks of pregnancy is termed intrauterine fetal death (or stillbirth). The management of intrauterine death includes:
1. Maternal reassurance and psychological support
2. Continued monitoring of the patient
3. Controlled infusion of heparin if necessary
4. Patient can return to the home environment

Question 8

A woman (third gravida) at 35 weeks of pregnancy experiences a loss due to stillbirth. Of the following, which is the possible management?

Accepted Answer

All of the above
Interruption of pregnancy with death of the fetus beyond 20 weeks of pregnancy is termed intrauterine fetal death or stillbirth. This can be a psychologically traumatic experience for a pregnant woman. The management of intrauterine death includes:
1. Maternal reassurance and psychological support
2. Continued monitoring of the patient
3. Controlled infusion of heparin if necessary
4. Patient can return to the home environment

Question 9

The first stage of labor begins with the onset of true labor pain and ends with full dilatation of the cervix. Which of the following is performed to assess well - being of the fetus in the first stage of labor?

Accepted Answer

Fetal heart rate monitoring and D. Monitoring for caput succedaneum development
The first stage of labor begins with the onset of true labor pain and ends with full dilatation of the cervix.Complications of the first stage of labor include membrane rupture, hypotonic uterine contraction, cervical dystocia, and fetal distress. Assessment of fetal well - being in first stage of labor includes:
1. Fetal heart rate monitoring
2. Monitoring of amniotic fluid (liquor)
3. Monitoring for caput succedaneum development
4. Degree of head - moulding

Question 10

Which of the following is an internal reproductive organ in the female by which the fertilized egg travels to the uterus?

Accepted Answer

Fallopian tube
There are two fallopian tubes, and these connect the ovaries to the uterus. Ectopic pregnancy occurs when the fertilized egg implants in a fallopian tube instead of the uterus. Internal reproductive organs in the human female include:
1. Vagina
2. Uterus
3. Fallopian tubes
4. Ovaries

Question 11

During pregnancy, women experence progressive physiological changes. The weight gain is usually progressive until the final 1 - 2 weeks of pregnancy. Depending upon baseline weight before pregnancy, which of the following is considered a normal rate of weight gain during pregnancy?

Accepted Answer

First trimester: 1 - 5 pounds
During pregnancy, women experence progressive physiological changes. Depending upon weight before pregnancy, normal first trimester weight gain is 1 - 5 pounds. Weight gain is one of the most visible physiological changes in pregnancy.

Question 12

A woman has a history of 6 weeks of amenorrhea. Which of the following symptoms suggests that she is pregnant?

Accepted Answer

Symptoms of pregnancy include:
1. Amenorrhea
2. Morning sickness
3. Increased frequency of micturation
4. Breast discomfort
5. Fatigue

Question 13

A woman (primigravida) developed vaginal bleeding in her first trimester of pregnancy. Which of the following can be a possible cause?

Accepted Answer

all of the above
The first stage starts from the onset of true labor pain, and ends with full dilatation of cervix. Causes of first trimester vaginal bleeding can include:
1. Miscarriage (spontaneous abortion)
2. Ectopic pregnancy rupture
3. Implantation bleeding
4. Uterine polyps
5. Molar pregnancy
6. Ruptured uterine varicose vein

Question 14

A woman (second gravida) developed lower abdominal pain during her third trimester of pregnancy. Of the following possible causes, which is most the most serious complication in terms of the fetus?

Accepted Answer

Intrauterine death
Intrauterine death refers to death of the fetus. Preeclampsia is a maternal complication characterized by high blood pressure in the mother as well as damage to an organ (such as the kidney). Ruptured uterus is a maternal complication that ranges from mild to severe. Postmaturity refers to a delivery beyond the expected date (and beyond 9 months of pregnancy).
Other causes of lower abdominal pain in the third trimester include:
1. Labor pain
2. Urinary tract infection
3. Abruptio placenta
4. Premature labor
5. Ruptured uterus
6. Torsion of gravid uterus

Question 15

Fundal height can provide a gross estimate of fetal gestational age in a pregnant woman. Of the following, which assessment is most typical of fundal height?

Accepted Answer

36th week: fundus at level of xiphoid process
The following is descriptive of typical changes in fundal height during pregnancy:
1. 16th week: level of fundus between symphysis pubis and umbilicus
2. 24th week: fundus at level of umbilicus
3. 36th week: fundus at level of xiphoid process

Question 16

The delivery process is described in terms of presentation, as well as fetal station, lie, and attitude. Which of the following presentations is most common at birth?

Accepted Answer

Cephalic presentation
In cephalic presentation, the fetus is in a longitudinal lie (and head enters the pelvis first). Vertex presentation is the most common type of cephalic presentation. In contrast, the newborn exits the pelvis with the buttocks or feet first during a breech presentation. Breech presentation occurs in 3 - 4% of all deliveries. In a compound delivery, there is presentation of a fetal extremity alonside a presenting part.

Question 17

During passage through the birth canal, the alternation in shape of the forthcoming head of the baby during labor is called molding. Which of the following statements is true regarding degrees of head molding?

Accepted Answer

All of the above
Molding is the alternation of the shape of the forecoming head of the baby while passing through the birth passage during labor. The molding typically disappears a few hours after birth. In vertex presentation (which is the normal delivery presentation), pressure on the head in the birth canal may mold it into an oblong shape. Caput succedaneum is a fetal complication in which fluid collects in the baby's scalp (and cephalohematoma refers to blood collected beneath the scalp); these complications also cause moulding to occur.

Question 18

A second gravida is at 36 weeks of pregnancy. Which of the following can be indicative of a high risk of fetal complications? (Choose all that apply)

Accepted Answer

Maternal age and B. Reproductive history
Pregnancies after age 40 have been linked to a higher risk of Down's syndrome in the baby. Factors associated with pregnancy risk include:
1. Maternal age at conception
2. Family history of fetal abnormalities
3. Reproductive abnormalities
4. History of medical diseases and conditions
5. Past surgical history

Question 19

A 40 year old pregnant woman (at 30 weeks of pregnancy) is experiencing severe vaginal bleeding. Eldery primigravida is a term used to describe a woman with a first pregnancy at 35 years of age or older. Of the following, which is the most likely complication experienced by this elderly primigravida?

Accepted Answer

Abruptio placenta
Abruptio placenta is a dangerous complication of pregnancy in which the placental lining has separated from the uterus. Other potential maternal complications of elderly primigravidae include:
1. Spontaneous abortion
2. Preeclampsia
3. Abruptio placenta
4. Postmaturity
5. Premature labor
6. Prolonged labor
7. Failed lactation
Prematurity, congenital malformations, and IUGR are possible fetal complications.

Question 20

Grand multiparity relates to a pregnant mother who has had five or more previous births. Which of the following is a maternal complication of grand multiparity?

Accepted Answer

All of the above
Grand multiparity relates to a pregnant mother who has had five or more previous births. Complications of grand multiparity can include:
1. Miscarriage (spontaneous abortion)
2. Placenta previa
3. Malpresentation
4. Preeclampsia
5. Eclampsia
6. Cord prolapse
7. Obstructed labor
8. Ruptured uterus

Quiz 2: Labor Birthand Immediate Postpartum